ODVA TechnologiesRegistration Form

Roundtable #62 for EtherNet/IP

This form serves as the Application and Agreement for Participation in the Roundtable. By registering to attend this event, the participant is agreeing that his/her participation in the Work Group is bound the Bylaws and policies of ODVA, Inc., including but not limited to, the IP Policy and the Policy Regarding Conduct of ODVA Activities for Compliance with Antitrust and Competition Laws.

ODVA will periodically review the list of participants in the Roundtable. If a participant has not attended a Roundtable in the preceding 12 months, ODVA may withdraw the participant from access to the ODVA collaboration forum for the Roundtable.

9:00 am - 5:00 pm on Tuesday September 10 and
8:00 am - noon on Wednesday September 11 (Local EDT)

Manchester, NH

Please complete in the English language.
* = Required information

Step 1. Complete Registration Information for the Roundtable Participant
Given (First) Name  *
Family (Last) Name  *
Title  *
Company Name  *
Street Address  *
City  *
State/Province   Zip/Post Code   Country  *
Phone with Country Code  *  Extension  
Email (work email address)

Step 2. Register  *

Registration for this event is limited to ODVA Members and Invited Experts. If you have any questions, please contact odva@odva.org.

* My company is an ODVA member, or I am an Invited Expert already approved by ODVA to attend this event.
* Please register me for the Roundtable for EtherNet/IP #62, Sept. 10-11, 2019
$150 members only — not a member? contact ODVA


Step 3:  Complete Payment Details *

Total Amount Due USD $

Please select and complete one of the following payment methods. Payment in full via check, credit card, or wire transfer is due at the time of registration and must be made in advance of attendance. For payments made by check, payment must be made in U.S. dollars drawn on a U.S. bank. Payments made by credit card will be processed in U.S. dollars.

Please transfer total amount indicated above, net of transfer fees. Transfer fees are charged to applicant.

      Select currency   USD   EUR   JPY   KRW

Bank account and routing information will be provided on ODVA invoice.

ODVA will charge your credit card for the event in U.S. dollars. Note that the final charge on your card may include additional charges by your bank for currency conversion.

1. Enter card type
2. Enter card number
3. Enter expiration date
4. Enter name as it appears on the card

1. Enter check number
2. Select method of delivery of check first class mail    courier
3. Purchase order number (if applicable)
4. Separately send the check to:


Step 4:   Verify Billing Details

Is your billing name and address the same as above in Step 1 for invoicing or payment processing? *

Please enter your billing information below.

Billing Name (Entity name as it should appear on invoice)  
Billing Address  
City   State/Province
Zip/Post Code   Country  


Step 5:  Submit Form Electronically

Attendee registration is limited due to class size and will be filled in order of receipt of registration. Confirmation of registration and additional details will be provided prior to the class.

Registrations are non-cancelable and non-refundable.


By submitting this form, you agree to receive electronic communications from ODVA.
To stop receiving communications from ODVA, please contact odva@odva.org.

For more information about your order or quote, please contact ODVA Headquarters.

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